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Pre-hospital Telemedicine Offers Additional Assessment Opportunities

Allegheny Health Network is the first in the state to launch a Pre-hospital Telemedicine program for use in the EMS community. The Lower Kiski and A-K Pulser Emergency Medical Services crew connected its first patient from her home to an emergency room physician at Allegheny Valley Hospital on June 30.

This innovative year-long pilot program, in which patients in their homes can speak directly to an emergency room physician via an iPad connection, offers new opportunities for EMS providers and patients who don’t want, or need to go to the emergency room.

“Telemedicine, the use of telecommunications technology to deliver health care, is a rapidly growing component of U.S. health care,” said Robert J. McCaughan, Vice President, Pre-hospital Care Services, at Allegheny Health Network. “This exciting innovation in Pre-hospital care is just the beginning of how we will be using telemedicine in our health care system in the coming years.”

“Exceptional work by the Allegheny Valley Hospital leadership and emergency department staff, and the EMS providers at Lower Kiski and A-K Pulser, made this possible,” McCaughan added. “Under the direction of Jerry Taylor, MD, EMS Medical Director at Allegheny Valley, they are focused on innovation and in constantly improving outreach to the communities they serve.”

On the first telemedicine consult, A-K Pulser and Lower Kiski EMS responded to a call from 59-year-old Barbara Verdu of Leechburg, who was experiencing anxiety, sweating and shakiness related to her diabetes.

The paramedics gave her orange juice and a glucose solution. Ms. Verdu felt better, and said she didn’t want to go to the hospital. The paramedics asked her if she would like to talk to a doctor, just to be sure.

To Ms. Verdu’s amazement, they connected her via an iPad with Allegheny Valley Hospital emergency medicine physician Andrea Fisk, MD, who had the chance to actually look at the patient while asking her questions, and cleared her to stay home and out of the hospital.

This consultation took place after months of planning with officials at Allegheny Health Network, Allegheny Valley Hospital, A-K Pulser and the Pennsylvania Department of Health. The telecommunications equipment was tested for its effectiveness and ease of use, as well as its compliance with patient privacy laws.

“The benefits of telemedicine to the patient are innumerable, offering direct in-home access to a physician who can see them and talk to them,” said Richard Gibbons, Director of the Bureau of Emergency Medical Services, Pennsylvania Department of Health. “I’m very excited about the potential of this program and glad to see that it is happening in a community hospital such as Allegheny Valley.”

Pre-hospital Telemedicine can be effective in a variety of selected situations, McCaughan said. “It can keep patients who don’t need hospital-based care out of the hospital, and it can get patients who need to be hospitalized into the hospital. It can also help a doctor determine whether a patient can be treated at a community hospital, or whether he or she needs to be transported to a destination offering specialized care, such as a certified stroke center.”

Telemedicine is particularly useful when EMS providers suspect a patient is suffering a stroke, McCaughan said. The doctor can actually watch the patient perform diagnostic tasks such as smiling or raising an arm, and listen to the patient talk, then decide whether transfer to a specialized stroke center is warranted.

An emergency physician might also refer a patient seen via telemedicine to an urgent care center, or advise the patient to call his or her primary care physician for an appointment. Patients must be conscious and alert, and must give spoken approval, to be treated via telemedicine.

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